Studies comparing the impact of plant-based meat alternatives (PBMAs) and animal-based meats consistently suggest that the former improve cardiovascular risk factors – which appears to have been confirmed recently by Canadian researchers seeking to investigate the long term health implications of PBMAs.
However, they suggest long-term randomised controlled trials and prospective cohort studies that evaluate CVD events (e.g, myocardial infarction, stroke) are essential to draw more definitive conclusions.
In Canada, the growing demand for PBMAs coincides with public health recommendations to reduce ultra-processed food consumption, and despite the variability in the contents and nutritional profiles PBMAs – and for instance, that some have high sodium levels – the nutritional profiles tend to reflect a heart-healthy dietary pattern, said the study team.
Their findings were published in the Canadian Journal of Cardiology, where lead author Matthew Nagra, ND, Vancouver, wrote: “While the plant-based meat market has experienced significant growth in recent years and more and more Canadians are enjoying plant-based burgers, surprisingly little is known about how these meat alternatives may impact health, and in particular, cardiovascular disease risk. We sought to review the available literature on the topic to identify what is currently known and to provide direction for future research.”
The authors reviewed research published from 1970 to 2023 on PBMAs, their contents, nutritional profiles, and impact on cardiovascular disease risk factors, such as cholesterol levels and blood pressure.
Their analysis shows:
There is substantial variability in the contents and nutritional profiles of PBMAs.
On average, PBMAs tend to have a more heart-healthy nutritional profile than meat, although the high sodium content of some products may be of concern.
PBMAs have been shown to improve some cardiovascular risk factors, including cholesterol levels, in several randomised controlled trials.
PBMAs have not been shown to raise blood pressure, despite the high sodium content of some products.
There is currently a lack of long-term research evaluating how these alternatives may affect the risk of developing a heart attack or stroke.
There is currently little research on the healthfulness of some common components of PBMAs, such as vital wheat gluten (seitan).
The authors were surprised to find a near complete lack of research on vital wheat gluten, which is the primary protein source incorporated into many popular PBMAs, and cardiovascular risk factors.
“Further,” said Nagra, “the lack of research on cardiovascular outcomes as of 2023 is shocking, given that there are randomised controlled trials evaluating risk factors dating back to 1990. More detailed research is needed in light of the increasing consumption of PBMAs and our lack of knowledge of how these products affect risk.”
In an accompanying editorial, J David Spence, CM, MD, FRCPC, FAHA, Professor Emeritus of Neurology & Clinical Pharmacology, Western University, and Director, Stroke Prevention & Atherosclerosis Research Centre, Robarts Research Institute, Canada, notes: “In an excellent review of PBMAs, Nagra, et al focus on reduction of cardiovascular risk factors, and the effects of various individual dietary factors on cardiovascular risk.
“However, what really matters is not the effect of individual components of a diet, nor the effect of diet on cardiovascular risk factors; it is the effect of diet on the actual risk of cardiovascular events such as myocardial infarction and stroke. Most physicians markedly underestimate the cardiovascular benefit of diet and place far too little emphasis on diet in the management of patients at high risk of cardiovascular events.”
He added a note of caution on the dietary implications of egg consumption.
“People at risk of cardiovascular disease should limit meat intake and avoid egg yolk, so plant-based meat substitutes and egg substitutes are helpful to patients wishing to reduce their cardiovascular risk. Their effect on reducing actual cardiovascular risk is undoubtedly much greater than their effect on cardiovascular risk factors.”
Study details
Animal vs Plant-Based Meat: A Hearty Debate.
Matthew Nagra, Felicia Tsam, Shaun Ward, Ehud Ur.
Published in the Canadian Journal of Cardiology on 25 June 2024
Abstract
Plant-based meat alternatives (PBMAs) are highly processed food products that typically replace meat in the diet. In Canada, the growing demand for PBMAs coincides with public health recommendations to reduce ultra-processed food consumption, which prompts the need to investigate the long-term health implications of PBMAs. This review assesses the available literature on PBMAs and cardiovascular disease (CVD), including an evaluation of their nutritional profile and impact on CVD risk factors. Overall, the nutritional profiles of PBMAs vary considerably but generally align with recommendations for improving cardiovascular health; compared with meat, PBMAs are usually lower in saturated fat and higher in polyunsaturated fat and dietary fibre. Some dietary trials that have replaced meat with PBMAs have reported improvements in CVD risk factors, including total cholesterol, low-density lipoprotein cholesterol, apolipoprotein B-100, and body weight. No currently available evidence suggests that the concerning aspects of PMBAs (eg, food processing and high sodium content) negate the potential cardiovascular benefits. We conclude that replacing meat with PBMAs may be cardioprotective; however, long-term randomised controlled trials and prospective cohort studies that evaluate CVD events (eg, myocardial infarction, stroke) are essential to draw more definitive conclusions.
CJC article – Animal vs Plant-Based Meat: A Hearty Debate (Open access)
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